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Ednan K Bajwa,1 Dawn Cislak,1 Amit Kumar,1 Dan Li,1 Eric J Messina,1 Tom Reynders,2 Jean-François Denef,2 Vasile Corcea,3 Ketan P Buch,4 Eseng Lai,1 S Aubrey Stoch1 1MRL, Merck & Co., Inc., Rahway, NJ, USA; 2Translational Medicine, MSD Belgium, Brussels, Belgium; 3PMSI Republican Clinical Hospital “T. Mosneaga”, ARENSIA EM Unit, Chisinau, Republic of Moldova; 4Department of Internal Medicine, Pulmonary and Critical Care Medicine, Lexington VA Healthcare, Lexington, KY, USACorrespondence: Ednan K Bajwa, Translational Medicine, Merck Research Laboratories Massachusetts LLC, 33 Avenue Louis Pasteur, MAILSTOP BMB-3-420, Boston, MA, 02115-5727, USA, Tel +1 617 992-3470, Email ednan.bajwa@merck.comPurpose: This phase 1 study (NCT04370873) evaluated safety and pharmacokinetics/pharmacodynamics (PK/PD) of MK-5475 in participants with pulmonary hypertension associated with COPD (PH-COPD).Methods: Eligible participants were 40– 80 years old with COPD (FEV1/FVC < 0.7; FEV1 > 30% predicted) and PH (mean pulmonary arterial pressure ≥ 25 mmHg). Participants were randomized 2:1 to MK-5475 or placebo via dry-powder inhaler once daily for 7 days in Part 1 (360 μg) or 28 days in Part 2 (380 μg). Safety was assessed by adverse events (AEs) and arterial blood oxygenation. Part-2 participants had pulmonary vascular resistance (PVR; primary PD endpoint) and pulmonary blood volume (PBV; secondary PD endpoint) measured at baseline and Day 28. A non-informative prior was used to calculate posterior probability (PP) that the between-group difference (MK-5475 – placebo) in mean percent reduction from baseline in PVR was less than − 15%.Results: Nine participants were randomized in Part 1, and 14 participants in Part 2. Median age of participants (86.4% male) was 68.5 years (41– 77 years); 95.5% had moderate-to-severe COPD. Incidences of AEs were comparable between MK-5475 and placebo: overall (5/14 [36%] versus 5/8 [63%]), drug-related (1/14 [7%] versus 2/8 [25%])

Christos Tsamasiotis,1 Gaelle Fiard,2 Pierre Bouzat,3 Patrice François,1 Guillaume Fond,4 Laurent Boyer,4 Bastien Boussat1,5 1Department of Clinical Epidemiology, Grenoble-Alps University Hospital; Laboratory TIMC-IMAG, UMR 5525 Joint Research Unit, National Center for Scientific Research, Faculty of Medicine, Grenoble Alps University, Grenoble, France; 2Department of Urology, Grenoble Alpes University Hospital, CNRS, Grenoble INP, TIMC, Université Grenoble Alpes, Grenoble, France; 3Department of Anaesthesia and Intensive Care, Centre Hospitalier Universitaire Grenoble, University Grenoble Alpes; INSERM U1216, Grenoble Institut Neurosciences, Grenoble, France; 4AP-HM, Aix-Marseille University, School of Medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Marseille, France; 5O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, CanadaCorrespondence: Bastien Boussat, Service d’épidémiologie et évaluation médicale, CHU Grenoble-Alpes, Boulevard de la Chantourne, La Tronche, 38700, France, Tel +33 4 76 76 69 96, Email bboussat@chu-grenoble.frBackground: Given the increasing focus on patient safety in healthcare systems worldwide, understanding the impact of Continuous Quality Improvement Programs (QIPs) is crucial. QIPs, including Morbidity and Mortality Conferences (MMCs) and Experience Feedback Committees (EFCs), have been identified as effective strategies for enhancing patient safety culture. These programs engage healthcare professionals in the identification and analysis of adverse events to foster a culture of safety (ie the product of individual and group value, attitudes, and perceptions about quality and safety). This study aimed to determine whether patient safety culture differed regarding care provider participation in MMCs and EFCs activities.Methods: A cross-sectional web-only survey was conducted in 2022 using the Hospital Survey on Patient Safety Culture (HSOPS) amon

Background and aims Stroke is the leading cause of adult-onset disability. Although clinical factors influence stroke outcome, there is a significant variability among individuals that may be attributed to genetics and epigenetics, including DNA methylation (DNAm). We aimed to study the association between DNAm and stroke prognosis. Methods and results To that aim, we conducted a two-phase study (discovery-replication and meta-analysis) in Caucasian patients with ischemic stroke from two independent centers (BasicMar [discovery, N = 316] and St. Pau [replication, N = 92]). Functional outcome was assessed using the modified Rankin Scale (mRS) at three months after stroke, being poor outcome defined as mRS > 2. DNAm was determined using the 450K and EPIC BeadChips in whole-blood samples collected within the first 24 h. We searched for differentially methylated positions (DMPs) in 370,344 CpGs, and candidates below p-value < 10–5 were subsequently tested in the replication cohort. We then meta-analyzed DMP results from both cohorts and used them to identify differentially methylated regions (DMRs). After doing the epigenome-wide association study, we found 29 DMPs at p-value < 10–5 and one of them was replicated: cg24391982, annotated to thrombospondin-2 (THBS2) gene (p-valuediscovery = 1.54·10–6; p-valuereplication = 9.17·10–4; p-valuemeta-analysis = 6.39·10–9). Besides, four DMRs were identified in patients with poor outcome annotated to zinc finger protein 57 homolog (ZFP57), Arachidonate 12-Lipoxygenase 12S Type (ALOX12), ABI Family Member 3 (ABI3) and Allantoicase (ALLC) genes (p-value < 1·10–9 in all cases). Discussion Patients with poor outcome showed a DMP at THBS2 and four DMRs annotated to ZFP57, ALOX12, ABI3 and ALLC genes. This suggests an association between stroke outcome and DNAm, which may help identify new stroke recovery mechanisms.

Background and aims Stroke is the leading cause of adult-onset disability. Although clinical factors influence stroke outcome, there is a significant variability among individuals that may be attributed to genetics and epigenetics, including DNA methylation (DNAm). We aimed to study the association between DNAm and stroke prognosis. Methods and results To that aim, we conducted a two-phase study (discovery-replication and meta-analysis) in Caucasian patients with ischemic stroke from two independent centers (BasicMar [discovery, N = 316] and St. Pau [replication, N = 92]). Functional outcome was assessed using the modified Rankin Scale (mRS) at three months after stroke, being poor outcome defined as mRS > 2. DNAm was determined using the 450K and EPIC BeadChips in whole-blood samples collected within the first 24 h. We searched for differentially methylated positions (DMPs) in 370,344 CpGs, and candidates below p-value < 10–5 were subsequently tested in the replication cohort. We then meta-analyzed DMP results from both cohorts and used them to identify differentially methylated regions (DMRs). After doing the epigenome-wide association study, we found 29 DMPs at p-value < 10–5 and one of them was replicated: cg24391982, annotated to thrombospondin-2 (THBS2) gene (p-valuediscovery = 1.54·10–6; p-valuereplication = 9.17·10–4; p-valuemeta-analysis = 6.39·10–9). Besides, four DMRs were identified in patients with poor outcome annotated to zinc finger protein 57 homolog (ZFP57), Arachidonate 12-Lipoxygenase 12S Type (ALOX12), ABI Family Member 3 (ABI3) and Allantoicase (ALLC) genes (p-value < 1·10–9 in all cases). Discussion Patients with poor outcome showed a DMP at THBS2 and four DMRs annotated to ZFP57, ALOX12, ABI3 and ALLC genes. This suggests an association between stroke outcome and DNAm, which may help identify new stroke recovery mechanisms.

Background and aims Stroke is the leading cause of adult-onset disability. Although clinical factors influence stroke outcome, there is a significant variability among individuals that may be attributed to genetics and epigenetics, including DNA methylation (DNAm). We aimed to study the association between DNAm and stroke prognosis. Methods and results To that aim, we conducted a two-phase study (discovery-replication and meta-analysis) in Caucasian patients with ischemic stroke from two independent centers (BasicMar [discovery, N = 316] and St. Pau [replication, N = 92]). Functional outcome was assessed using the modified Rankin Scale (mRS) at three months after stroke, being poor outcome defined as mRS > 2. DNAm was determined using the 450K and EPIC BeadChips in whole-blood samples collected within the first 24 h. We searched for differentially methylated positions (DMPs) in 370,344 CpGs, and candidates below p-value < 10–5 were subsequently tested in the replication cohort. We then meta-analyzed DMP results from both cohorts and used them to identify differentially methylated regions (DMRs). After doing the epigenome-wide association study, we found 29 DMPs at p-value < 10–5 and one of them was replicated: cg24391982, annotated to thrombospondin-2 (THBS2) gene (p-valuediscovery = 1.54·10–6; p-valuereplication = 9.17·10–4; p-valuemeta-analysis = 6.39·10–9). Besides, four DMRs were identified in patients with poor outcome annotated to zinc finger protein 57 homolog (ZFP57), Arachidonate 12-Lipoxygenase 12S Type (ALOX12), ABI Family Member 3 (ABI3) and Allantoicase (ALLC) genes (p-value < 1·10–9 in all cases). Discussion Patients with poor outcome showed a DMP at THBS2 and four DMRs annotated to ZFP57, ALOX12, ABI3 and ALLC genes. This suggests an association between stroke outcome and DNAm, which may help identify new stroke recovery mechanisms.

Background and aims Stroke is the leading cause of adult-onset disability. Although clinical factors influence stroke outcome, there is a significant variability among individuals that may be attributed to genetics and epigenetics, including DNA methylation (DNAm). We aimed to study the association between DNAm and stroke prognosis. Methods and results To that aim, we conducted a two-phase study (discovery-replication and meta-analysis) in Caucasian patients with ischemic stroke from two independent centers (BasicMar [discovery, N = 316] and St. Pau [replication, N = 92]). Functional outcome was assessed using the modified Rankin Scale (mRS) at three months after stroke, being poor outcome defined as mRS > 2. DNAm was determined using the 450K and EPIC BeadChips in whole-blood samples collected within the first 24 h. We searched for differentially methylated positions (DMPs) in 370,344 CpGs, and candidates below p-value < 10–5 were subsequently tested in the replication cohort. We then meta-analyzed DMP results from both cohorts and used them to identify differentially methylated regions (DMRs). After doing the epigenome-wide association study, we found 29 DMPs at p-value < 10–5 and one of them was replicated: cg24391982, annotated to thrombospondin-2 (THBS2) gene (p-valuediscovery = 1.54·10–6; p-valuereplication = 9.17·10–4; p-valuemeta-analysis = 6.39·10–9). Besides, four DMRs were identified in patients with poor outcome annotated to zinc finger protein 57 homolog (ZFP57), Arachidonate 12-Lipoxygenase 12S Type (ALOX12), ABI Family Member 3 (ABI3) and Allantoicase (ALLC) genes (p-value < 1·10–9 in all cases). Discussion Patients with poor outcome showed a DMP at THBS2 and four DMRs annotated to ZFP57, ALOX12, ABI3 and ALLC genes. This suggests an association between stroke outcome and DNAm, which may help identify new stroke recovery mechanisms.

Background and aims Stroke is the leading cause of adult-onset disability. Although clinical factors influence stroke outcome, there is a significant variability among individuals that may be attributed to genetics and epigenetics, including DNA methylation (DNAm). We aimed to study the association between DNAm and stroke prognosis. Methods and results To that aim, we conducted a two-phase study (discovery-replication and meta-analysis) in Caucasian patients with ischemic stroke from two independent centers (BasicMar [discovery, N = 316] and St. Pau [replication, N = 92]). Functional outcome was assessed using the modified Rankin Scale (mRS) at three months after stroke, being poor outcome defined as mRS > 2. DNAm was determined using the 450K and EPIC BeadChips in whole-blood samples collected within the first 24 h. We searched for differentially methylated positions (DMPs) in 370,344 CpGs, and candidates below p-value < 10–5 were subsequently tested in the replication cohort. We then meta-analyzed DMP results from both cohorts and used them to identify differentially methylated regions (DMRs). After doing the epigenome-wide association study, we found 29 DMPs at p-value < 10–5 and one of them was replicated: cg24391982, annotated to thrombospondin-2 (THBS2) gene (p-valuediscovery = 1.54·10–6; p-valuereplication = 9.17·10–4; p-valuemeta-analysis = 6.39·10–9). Besides, four DMRs were identified in patients with poor outcome annotated to zinc finger protein 57 homolog (ZFP57), Arachidonate 12-Lipoxygenase 12S Type (ALOX12), ABI Family Member 3 (ABI3) and Allantoicase (ALLC) genes (p-value < 1·10–9 in all cases). Discussion Patients with poor outcome showed a DMP at THBS2 and four DMRs annotated to ZFP57, ALOX12, ABI3 and ALLC genes. This suggests an association between stroke outcome and DNAm, which may help identify new stroke recovery mechanisms.

Samuel Mbadu Lelo,1,2 François-Pantaléon Musungayi Kajingulu,1,3,4 Jean-Robert Makulo,1,2 Yannick Mayamba Nlandu,1,5 Justine Busanga Bukabau,1,5 Pierre Koso Mbulupasu,1,6 Augustin Luzayadio Longo,1 Jeanine Nina Losa Luse,7 Vieux Momeme Mokoli,1,2 Ernest Kiswaya Sumaili,1 Nazaire Mangani Nseka1 1Hemodialysis Center, Division of Nephrology, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo; 2Hemodialysis Center, Ngaliema Medical Center, Kinshasa, Democratic Republic of the Congo; 3Dialysis Center, HJ Hospital, Kinshasa, Democratic Republic of the Congo; 4Department of Internal Medicine, Saint-Joseph Hospital, Kinshasa, Democratic Republic of the Congo; 5Hemodialysis Center, Centre Médical de Kinshasa, Kinshasa, Democratic Republic of the Congo; 6Department of Internal Medicine, Clinique Ngaliema, Kinshasa, Democratic Republic of the Congo; 7Hemodialysis Center, Hôpital Général de Référence de Kinshasa, Kinshasa, Democratic Republic of the CongoCorrespondence: Jean-Robert Makulo, Email jrmakulo2016@gmail.comBackground: Data on 25 [OH] vitamin D and intact parathyroid hormone [iPTH] in hemodialysis patients are very limited in sub-Saharan African countries. The present study aimed to assess the magnitude of hypovitaminosis D, and to evaluate the achievement of iPTH KDIGO 2017 targets among chronic hemodialysis patients followed in Kinshasa.Methods: We conducted a multicenter cross-sectional study in 6 hospitals in Kinshasa. All patients followed on hemodialysis for more than 3 months were included. Hypovitaminosis D was defined as < 30 ng/mL (insufficiency = 20– 29 ng/mL; deficiency if < 20 ng/mL) and the targets for iPTH values were based on the 2017 KDIGO guidelines. The determinants for hypovitaminosis D were evaluated by logistic regression.Results: 251 patients [mean age 56 ± 14 years, 72.5% men, 63% hypertensive, 31% diabetic, 100% supplemented with native 25 [OH] vitamin D + CaCO3 were included. Hypovitaminosis D was found

Thibaud Soumagne,1 François Maltais,1 François Corbeil,2 Bruno Paradis,3 Marc Baltzan,4 Paula Simão,5 Araceli Abad Fernández,6 Richard Lecours,7 Sarah Bernard,1 Yves Lacasse1 for the INOX Trial Group1Quebec Heart and Lung Institute, Laval University, Quebec, Canada; 2Trois-Rivières Affiliated Hospital, Trois-Rivières, Canada; 3Laval Integrated Center of Health and Social Services, Laval, Canada; 4Mount Sinai Hospital, McGill University, Montreal, Canada; 5Pedro Hispano Hospital, Matosinhos, Portugal; 6Getafe University Hospital, Getafe, Spain; 7Hôtel-Dieu de Lévis Affiliated Hospital, Lévis, CanadaCorrespondence: Yves Lacasse, Quebec Heart and Lung Institute - Laval University, 2725 Ste-Foy Road, Québec, P, Québec, G1V 4G5, Canada, Tel +1 418-656-4747, Fax +1 418-656-4762, Email Yves.Lacasse@med.ulaval.caRationale: Short-term oxygen therapy (STOT) is often prescribed to allow patients with chronic obstructive pulmonary disease (COPD) to be discharged safely from hospital following an acute illness. This practice is widely accepted without being based on evidence.Purpose: Our objective was to describe the characteristics and outcomes of patients with COPD who received STOT.Patients and Methods: The study was a secondary analysis of the INOX trial, a 4-year randomised trial of nocturnal oxygen in COPD. The trial indicated that nocturnal oxygen has no significant effect on survival or progression to LTOT, allowing our merging of patients who received nocturnal oxygen and those who received placebo into a single cohort to study the predictors and outcomes of STOT regardless of the treatment received during the trial.Results: Among the 243 participants in the trial, 60 required STOT on at least one occasion during follow-up. Patients requiring STOT had more severe dyspnoea and lung function impairment, and lower PaO2 at baseline than those who did not. STOT was associated with subsequent LTOT requirement (hazard ratio [HR]: 4.59; 95% confidence interval [CI]

Fabrice Ferré,1,&ast; Marie-Léa Piel-Julian,2,&ast; Francis Tincres,1 Cyndie Ba,1 Rémi Menut,1 Anne Ferrier,1 Laetitia Bosch,1 Charlotte Martin,1 François Labaste,1 François Montastruc,3 Agnès Sommet,3 Laurent Balardy,2,&ast; Vincent Minville1,4,&ast; 1Département d’Anesthésie-Réanimation et de Médecine Péri Opératoire, Centre Hospitalo-universitaire (CHU) de Toulouse, Toulouse, France; 2Service d’Oncogériatrie, Centre Hospitalo-universitaire (CHU) de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole (IUCT-O), Toulouse, France; 3Laboratoire de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de Pharmacovigilance, de Pharmacoépidémiologie et d’Informations sur le Médicament, Pharmacopôle Midi-Pyrénées, INSERM UMR 1027, CIC INSERM 1436, CHU Toulouse, Toulouse, France; 4RESTORE, UMR 1301 Inserm - 5070 CNRS - Université Paul Sabatier, Université de Toulouse, Toulouse, France&ast;These authors contributed equally to this workCorrespondence: Fabrice Ferré, Hôpital Pierre-Paul Riquet, CHU Purpan, place du Dr Baylac, Toulouse, 31059, France, Tel +33 5 61 77 99 88, Email ferre.f@chu-toulouse.frBackground: Postoperative delirium frequently occurs in the elderly after hip fracture surgery and is associated with poor outcomes. Our aim was to identify a correlation between the atropinic burden (AB) due to drugs with clinical antimuscarinic effect and the occurrence of postoperative delirium.Methods: We carried out a prospective, monocentric, observational study including 67 patients over 65 years of age who underwent hip fracture surgery. The addition of the anticholinergic weight of each drug was calculated at different time points to distinguish the prehospital, intra- and postoperative part of the AB. A multivariate analysis was carried out to identify the explanatory variables associated with postoperative delirium.Results: Patients were 78 [71– 86] years old. The time from admission to surgery was 1

The ongoing search for energy conversion technologies that are more efficient, affordable, and sustainable than traditional solar cells have led researchers to look at other technologies. Among these technologies, perovskite-based solar cells seem increasingly credible, as they have the potential to achieve high energy conversion efficiencies that rival or even surpass those of silicon solar cells, which currently dominate the market. Despite this enormous potential, perovskite solar cells face several problems holding them back. For this study, we employed the SCAPS-1D software which is a simulation software developed at the University of gent in Belgium for conducting numerical simulations of a perovskite solar cell. The calculation methodology is the finite difference method using the transport, Poisson, and continuity equations with predefined boundary conditions. Through this simulation, we studied the influence of absorber thickness, lifetime, carrier diffusion length, and defect density on the overall behavior of the electrical parameters. The best performances are observed when the absorber thickness is equal to 0.5 μm and the defect density is less than 1016 cm-3.

Ganamé Abasse Ouédraogo,1,2 Hama Cissé,1 Henri Sidabéwindin Ouédraogo,1 Boukaré Kaboré,1 Roukiatou Traoré,1 Yves Traoré,1 Ismael Henri Nestor Bassolé,3 François Tchoumbougnang,2 Aly Savadogo1 1Laboratoire de Biochimie et Immunologie Appliquées (LaBIA), Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso; 2Institut des Sciences Halieutiques (ISH) à Yabassi, Université de Douala, Douala, Cameroun; 3Laboratoire de biologie moléculaire, d’épidémiologie et de surveillance des bactéries et virus transmis par les aliments (LaBESTA), Université Joseph Ki-ZERBO, Ouagadougou, Burkina FasoCorrespondence: Aly Savadogo, Tel +226 70356227, Email alysavadogo@gmail.comBackground: In Burkina Faso, suspicions have been raised that hospital liquid effluents are a source of microbiological contaminants in surface waters of urban and peri-urban areas. This study aimed to determine the antibiotic residues and the antibiotic resistance phenotype of potential pathogenic bacteria in the hospital liquid effluents discharged into nature by the CHUs Bogodogo, Yalgado Ouédraogo and the WWTS of Kossodo.Methods: Fifteen samples of liquid effluents discharged into nature were collected. Antibiotic residues were identified by HPLC. A wavelength of 254 nm for the UV detector was set. Antibiotic testing was realized according to CASFM 2019 recommendations.Results: Three molecules including Amoxicillin, Chloramphenicol and Ceftriaxone were detected in 13 samples. The strains characterized were 06 E. coli, 09 Pseudomonas spp, 05 Staphylococcus aureus and 04 Salmonella spp. Thus, none of the strains was resistant to Imipenem, but they were resistant to Amoxiclav with rates of 83.33% (E. coli), 88.88% (Pseudomonas spp) and 100% (Staphylococcus aureus and Salmonella spp).Conclusion: Ouagadougou hospital liquid effluents discharged into nature are contaminated with antibiotic residues and potential pathogenic bacteria.Keywords: wastewater, antibiotics residues, antibiotics resistan

Léa Antoine,1 Eve Puzenat,1 Dragos Popescu,2 Romain Charollais,3 Flora Dresco,3 Anne-Sophie Dupond,2 Dominique Salard,4 Marie-Christine Drobacheff-Thiebaut,1 Anaïs Zanella,1 Anne Ducournau,2 Iréne Gallais-Serezal,1 François Aubin1,5 1Department of Dermatology, University Hospital, Besançon, France; 2Department of Dermatology, Hôpital Nord Franche Comté, Trevenans, France; 3Department of Dermatology, Centre Hospitalier, Vesoul, France; 4Department of Dermatology, Centre Hospitalier, Pontarlier, France; 5Inserm 1098 RIGHT, University of Franche Comté, Besançon, FranceCorrespondence: François Aubin, Centre hospitalier Universitaire, Service de Dermatologie, 3 Bd Fleming, Besançon, 25000, France, Email francois.aubin@univ-fcomte.frPurpose: There are few data on the practical use of dupilumab by the patients and on the patients’ experience with this treatment.Objective: The objective of our study was to describe the experience and perception of dupilumab treatment in patients with atopic dermatitis (AD).Patients and Methods: We conducted a multicenter retrospective observational study including adult patients with moderate to severe AD treated with dupilumab between January 2017 and December 2021. Clinical characteristics were collected and a questionnaire was sent to all patients. It consisted of different parts including the injection method and different numeric rating scales (NRS) evaluating the patient’s satisfaction and the constraints related to the treatment.Results: Eighty-two patients were included and the information was available for 77 patients who responded to the questionnaire. Injection of dupilumab was performed by a nurse in 47% (n=36) of patients and 43% (n=33) were autonomous. Injections were performed by a family member for 7 patients or by the general practitioner (1 patient). A wearing-off of the beneficial effect of dupilumab was reported by 47% of patients leading to shorten the dosing interval. In contrast, dose spacing was report

The ongoing search for energy conversion technologies that are more efficient, affordable, and sustainable than traditional solar cells have led researchers to look at other technologies. Among these technologies, perovskite-based solar cells seem increasingly credible, as they have the potential to achieve high energy conversion efficiencies that rival or even surpass those of silicon solar cells, which currently dominate the market. Despite this enormous potential, perovskite solar cells face several problems holding them back. For this study, we employed the SCAPS-1D software which is a simulation software developed at the University of gent in Belgium for conducting numerical simulations of a perovskite solar cell. The calculation methodology is the finite difference method using the transport, Poisson, and continuity equations with predefined boundary conditions. Through this simulation, we studied the influence of absorber thickness, lifetime, carrier diffusion length, and defect density on the overall behavior of the electrical parameters. The best performances are observed when the absorber thickness is equal to 0.5 μm and the defect density is less than 1016 cm-3.

Michael Bogart,1 Guillaume Germain,2 François Laliberté,2 Malena Mahendran,2 Mei Sheng Duh,3 Kristi DiRocco,4 Stephen G Noorduyn,5,6 Rosirene Paczkowski,7 Ronald Balkissoon8 1U.S. Value Evidence and Outcomes, R&D U.S., GSK, Research Triangle Park, Durham, NC, USA; 2Groupe d’Analyse, Ltée, Montréal, QC, Canada; 3Analysis Group, Inc., Boston, MA, USA; 4U.S. Medical Affairs, GSK, Collegeville, PA, USA; 5Global Value Evidence and Outcomes, GSK, Mississauga, ON, Canada; 6Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; 7Value Evidence and Outcomes, GSK, Collegeville, PA, USA; 8National Jewish Health, Denver, CO, USACorrespondence: Kristi DiRocco, U.S. Medical Affairs, GSK, Collegeville, PA, USA, Tel +1 610-412-7175, Email kristi.k.dirocco@gsk.comPurpose: Real-world asthma control data among patients initiating fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) are limited. This study assessed rescue medication use and asthma-related exacerbations in patients with asthma before and after initiating single-inhaler FF/UMEC/VI using administrative claims data.Patients and Methods: This retrospective, pre-post cohort study analyzed data from the IQVIA PharMetrics Plus database (September 18, 2016‒March 31, 2020). Patients aged ≥ 18 years that had ≥ 1 dispensing of single-inhaler FF/UMEC/VI 100/62.5/25 mcg (first dispensing = index date), ≥ 12 months of continuous health insurance enrollment prior to (pre-treatment) and following (post-treatment) FF/UMEC/VI initiation and ≥ 1 diagnosis of asthma during the pre-treatment period or on the index date were included. The primary endpoint was the number of oral corticosteroid (OCS) dispensings per patient per year during pre- and post-treatment periods. Secondary endpoints included asthma-related exacerbation rates and short-acting β2-agonist (SABA) use. Comparisons between pre- and post-treatment periods were made using risk and rate ratios.Results: O

Michael Bogart,1 Guillaume Germain,2 François Laliberté,2 Dominique Lejeune,2 Mei Sheng Duh3 1U.S. Value Evidence and Outcomes, R&D US, GSK, Research Triangle Park, NC, USA; 2Groupe d’analyse, Ltée, Montréal, QC, Canada; 3Analysis Group, Boston, MA, USACorrespondence: Mei Sheng Duh, Analysis Group, 111 Huntington Ave 14th Floor, Boston, MA, 02199, USA, Tel +1 617 425 8131, Email mei.duh@analysisgroup.comPurpose: There is limited literature regarding real-world treatment patterns of patients with COPD, particularly since the introduction of once-daily single-inhaler triple therapy with fluticasone furoate/umeclidinium/vilanterol in 2017. Here, we evaluated treatment patterns of patients with COPD before and after a COPD exacerbation.Patients and Methods: Retrospective, descriptive study using medical and pharmacy claims data and enrollment information from the Optum® Clinformatics® Data Mart database. Patients aged ≥ 40 years with ≥ 1 COPD exacerbation on or after September 18, 2017 were included. The index date was the last day of the first COPD exacerbation (ie day of visit for a moderate exacerbation or discharge date for a severe exacerbation). The baseline period was 12 months prior to index and the follow-up period (≥ 3 months) spanned from index until the earliest of health plan disenrollment, end of data availability (September 30, 2020), or death. Treatment patterns were evaluated during baseline and follow-up, with a focus on medication switching in the 90 days pre- and post-index.Results: COPD exacerbations were identified in 307,727 patients (125,942 severe; 181,785 moderate). Mean age at index was 72.8 years; 56.3% were female. Before and after first exacerbation, 37.7% and 48.2% of patients used ≥ 1 controller medication, respectively. In the 90 days pre-index, ICS, LABA, and LAMA medications were used by 27.5% of patients. Of these users, 64.3% remained on the same medication class, 21.7% discontinued, and 14.1% switched medication

Joane Le Carré,1,2 François Luthi,2– 4 Cyrille Burrus,2,3 Michel Konzelmann,2,5 Philippe Vuistiner,1,2 Bertrand Léger,1,2 Charles Benaïm1,4 1Department of Medical Research, Clinique Romande de Réadaptation, Sion, Switzerland; 2Institute for Research in Rehabilitation, Clinique Romande de Réadaptation, Sion, Switzerland; 3Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, Switzerland; 4Department of Physical Medicine and Rehabilitation, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; 5Assessment and Consultation Department, Clinique Romande de Réadaptation, Sion, SwitzerlandCorrespondence: Joane Le Carré, Ave Grand-Champsec 90, Sion, 1950, Switzerland, Tel +41 27 603 20 73, Email joane.lecarre@crr-suva.chPurpose: Chronic pain is a complex phenomenon. Understanding its multiple dimensions requires the use of a combination of several patient-reported outcome measures (PROMs). However, completing multiple PROMs is time-consuming and can be a burden for patients. The objective of our study was to simultaneously reduce the French versions of the Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia (TSK) questionnaires to enable their use in an ambulatory and clinical settings.Patients and Methods: We conducted a clinical study between May 2014 and August 2020 in our rehabilitation center. 1428 chronic musculoskeletal pain patients (CMSP) were included. The originality of our approach is that the reduction method included qualitative as well as quantitative analyses. The study was divided into two parts: 1) reduction of the questionnaires (n=1363) based on internal consistency (item-to-total correlation), principal component analysis (item loadings), Rasch analysis (infit/outfit), floor and ceiling effect (quantitative analyses) and expert judgment of items (qualitative analysis), and 2) validation of the reduced questionnaires (n=65), including test–retest reliability (intraclass

Hong Phuoc Duong,1,&ast; Bertrand Léger,1 Stefan Markus Scholz-Odermatt,2 Cyrille Burrus,1,3 Philippe Vuistiner,1 Michel Konzelmann,1,3 François Luthi1,3,4,&ast; 1Department of Medical Research, Clinique romande de réadaptation, Sion, 1951, Switzerland; 2Department of Statistics, Sammelstelle für die Statistik der Unfallversicherung (SSUV), c/o Swiss Accident Insurance Fund (Suva), Lucerne, 6002 Switzerland; 3Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, 1951, Switzerland; 4Department of Rheumatology and Rehabilitation, Hôpital Orthopédique, University and University Hospital of Lausanne, Lausanne, 1011, Switzerland&ast;These authors contributed equally to this workCorrespondence: Bertrand Léger, Tel +41 27 603 2075, Email Bertrand.Leger@crr-suva.chPurpose: To assess and compare the healthcare costs, time to fitness for work (TFW) between chronic complex regional pain syndrome (CRPS) and non-CRPS; and identify factors associated with these outcomes in a comparative longitudinal study.Patients and Methods: 148 patients with chronic CRPS of the hand and 273 patients with chronic hand impairments but without CRPS (non-CRPS) were admitted at a Swiss rehabilitation clinic between 2007 and 2016. Healthcare costs and TFW were retrieved from insurance data over 5 years after the accident. Socio-demographic factors, biopsychosocial complexity measured by means of the INTERMED questionnaire, pain intensity and DASH disability scores were collected during rehabilitation. Generalized estimation equations and Cox proportional-hazards models were used to identify factors associated with outcomes.Results: Healthcare costs were increased by 20% for the CRPS versus non-CRPS group (coefficient = 1.20, 95% CI = 1.08– 1.35, p< 0.001). The median TFW was longer for CRPS than non-CRPS patients (816 vs 672 days, p = 0.02). After adjusting for covariates, TFW did not differ between the two groups (hazard ratio = 0.94, 95% CI

Donatha Uwanyirigira,1,2 Emmanuel Biracyaza,3,4 Innocent Uzabakiriho,2 Jared Omolo,5 François Hakizayezu,1 Manasse Nzayirambaho1 1Department of Epidemiology and Biostatistics, University of Rwanda, Kigali, Rwanda; 2Byumba District Hospital, Ministry of Health, Byumba, Rwanda; 3School of Rehabilitation, Faculty of Medicine, Université de Montréal, Quebec, Montréal; 4Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire Sur la Réadaptation En Déficience Physique de Montréal, Quebec, Canada; 5Field Epidemiology Training Program (FELTP), Centers for Disease Control and Prevention (CDC) in Rwanda, Kigali, RwandaCorrespondence: Donatha Uwanyirigira, Tel +250788459752, Email uwanyidonatha@gmail.comIntroduction: The human immunodeficiency virus (HIV) and the use of antiretroviral therapy (ART) are influential elements contributing to hypertension, which is a public health concern particularly in sub-Saharan Africa where its underdiagnosis and limited investigation persist. Moreover, hypertension prevails at higher rates among individuals living with HIV (PLWH) in comparison to the general population. Therefore, our study determined the prevalence of hypertension and its associated factors among PLWH who are undergoing ART treatment at Byumba District Hospital.Methods: A cross-sectional study design was conducted among 406 PLWH over the age of 14 years who were undergoing ART within the HIV department. We performed statistical analyses using STATA version 13. Significant independent variables identified in the bivariate analysis were further exported in a multivariable logistic regression model to ascertain their association with hypertension. This model elucidated factors associated with hypertension, presenting outcomes through odds ratios and their respective 95% confidence intervals, with statistical significance set at p < 0.05.Results: The prevalence of hypertension was 24.7%, which means that roughly 1 in

In this study, we analyze the effect of non-equilibrium phase change on transfer at low water content in a sandy soil by considering the contribution of film flow in the motion of liquid water. Indeed, most of the non-equilibrium study methods use for hydraulic conductivity, the van Genuchten-Mualem (VGM) capillary model which does not consider the film flow occurred at low water contents. Thus, we conduct a theoretical study by using an unidirectional non-equilibrium two phase flow model to simulate water transfers by filtration of liquid water and diffusion of water vapour coupled by liquid/gas phase change. We then compare the results of the non-equilibrium with the classical model of VGM for hydraulic conductivity function and another model considering the film flows. The numerical simulation is based on a column of sandy soil exposed to a controlled atmosphere. We observe that the shapes of the profiles of fluxes (liquid water, liquid/vapour non-equilibrium phase change) simulated using the capillary model are very different from those obtained with the model considering the film flow. In this last case, the liquid/gas non-equilibrium is not noticeable as in the case of the capillary model. It seems that the film flows occult the water vapour diffusion by delaying the phase change process, therefore a lower concentration of water vapour into the soil than in the case where the capillary flow alone has been considered.

Sarah Gephine,1,2 Olivier Le Rouzic,3,4 François Machuron,5 Benoit Wallaert,3 Cécile Chenivesse,3,4 Didier Saey,2 François Maltais,2 Patrick Mucci,1 Jean-Marie Grosbois6 1Univ. Lille, Univ. Artois, Univ. Littoral Côte d’Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille F-59000, France; 2Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada; 3CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence Constitutif des Maladies Pulmonaires Rares, Lille F-59000, France; 4Univ. Lille, Lille F-59000, France; 5Department of Biostatistics, Univ. Lille, CHU Lille, EA 2694 - Santé Publique: Épidémiologie et Qualité des Soins, Lille F-59000, France; 6FormAction Santé, Pérenchies, FranceCorrespondence: Jean-Marie GrosboisFormAction Santé, Pérenchies, Zone d’Activité du Bois, Rue de Pietralunga, Pérenchies, F-59840, FranceEmail jmgrosbois@formactionsante.comBackground: Long-term effectiveness of pulmonary rehabilitation (PR) is still uncertain in older people with severe chronic obstructive pulmonary disease (COPD). The objective was to compare the effects of home-based PR in people with COPD above and below the age of 70 years.Methods: In this retrospective study, 480 people with COPD were recruited and divided into those ≤ 70 (n=341) and those > 70 years of age (n=139). All participants underwent an 8 weeks of home-based PR, consisting of a weekly supervised 90-minute home session. Six-minute stepper test (6MST), timed-up and go test (TUG), Hospital Anxiety and Depression Scale, and Visual Simplified Respiratory Questionnaire (VSRQ) were assessed at baseline (M0), at 2 (M2), 8 (M8), 14 (M14)

In this study, we propose a new method for detecting wet periods by using telecommunications Commercial Microwave Links (CML). The purpose of the study is to automatically find rain time slots. The attenuation of the microwave signal, propagating between a transmitting antenna and a receiving one, due to the variations of the climatic conditions over the link, is a non-stationary signal. When a rain event occurs over a CML, the attenuation signal level increases proportionally to the rain amount. This level decreases again at the end of the rain. These abrupt variations are exploited here to detect rainy time slots. The proposed method consists in splitting the attenuation signal into frames and computing the variation of the energy between consecutive frames. To determine whether the current frame corresponds to a wet period, the proposed method, named Energy Variation (EVA), compares the variation of the energy with a given threshold, while taking into account the status of the previous frame. Simulation results from real attenuation data of the mobile phone operator Telecel Faso SA (Burkina Faso) show that the proposed method allows the detection of 84.61% of rainy events. The Matthews Correlation Coefficient (MCC) is higher than 0.9, which demonstrates that EVA can discriminate between wet and dry periods with high accuracy.

Marie-Thérèse Aloy,1,&ast; Jacqueline Sidi Boumedine,2,&ast; Agathe Deville,2,3 David Kryza,2 Arnaud Gauthier,1,4 Delphine Brichart-Vernos,1,5 Grégoire Ollier,1 Veronica La Padula,5 François Lux,5 Olivier Tillement,5 Claire Rodriguez-Lafrasse,1,4,&ast; Marc Janier2,3,&ast; 1Laboratory of Cellular and Molecular Radiobiology, UMR CNRS5822/IP2I, Lyon-Sud Medical School, Univ Lyon, Lyon 1 University, Oullins, France; 2CNRS, LAGEPP, UMR5007, IMTHERNAT, Lyon 1 University, Hospital Edouard Herriot, Lyon, France; 3Department of Nuclear Medicine, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France; 4Department of Biochemistry and Molecular Biology, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France; 5Light Matter Institut UMR CNRS 5306, Lyon 1 University, Villeurbanne, France&ast;These authors contributed equally to this workCorrespondence: Marc Janier, Department of Nuclear Medicine, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, 69634, France, Tel +33472356999, Fax +33472357345, Email marc.janier@univ-lyon1.frPurpose: Chondrosarcomas (CHSs), which represent 20% of primary bone tumors in adults, are mostly resistant to radio- and chemotherapy. It is therefore essential that new therapeutic approaches, targeted to the tumour, be developed to improve the prognosis of patients. The effectiveness, as a radiosensitizing agent, of gadolinium oxide nanoparticles (GdoNP, AGuIX®) nanoparticles in CHS was evaluated in vitro, in spheroid CHS models allowing to reproduce cell-cell extracellular matrix interactions, and, in vivo, in a nude mouse model with heterotopic tumour xenograft.Methods: Spheroids from SW1353 and HEMC-SS cells were characterized by confocal microscopy with or without GdoNP treatment. Real-time microscopy enabled quantification of cell viability, cell migration and invasion. In vivo, the efficacy of the association of GdoNP combined with a single (4Gy) or fractionated (4x1Gy) irradiation wa

Anne-Claire Fougerousse,1 François Maccari,1,2 Philippe Guillem,3 Ziad Reguiai4 On behalf of the GEM ResoVerneuil1Dermatology Department, Military Teaching Hospital Bégin, Saint Mandé, France; 2Dermatology, Private Practice, Saint-Maur-des-Fossés, France; 3Visceral Surgery department, Clinique du Val d’Ouest, Ecully, France; 4Dermatology Department, Polyclinique Courlancy-Bezannes, Reims, FranceCorrespondence: Anne-Claire Fougerousse, Dermatology department, Military Teaching Hospital Bégin, Saint Mandé, France, Tel +1 43 98 50 00, Email ac.fougerousse@gmail.comPurpose: Antibiotics are used for hidradenitis suppurativa’s management with limited evidence. Choice of antibiotics is based on small randomized controlled trial or open case-series.Patients and Methods: We performed a practice survey in Resoverneuil, a French network of physicians treating hidradenitis suppurativa, to identify the antibiotic strategy according to the Hurley stage. Online questionnaire was sent to all members of ResoVerneuil between January and February 2021.Results: In total, 108 physicians answered the survey: 37.6% were hospital based, 34.6% had a private practice and 27.8% a mixed practice, and 13.8% had a dedicated consultation for hidradenitis suppurativa. Sixty-three physicians reported seeing fewer than 5 patients with hidradenitis suppurativa per month; 29 seeing 5 to 15 patients per month; and 9 seeing more than 15 patients per month. More than 90% declared prescribing antibiotics for flares in Hurley 1 and 2 stages, and 83% in Hurley 3 stages, mostly amoxicillin-clavulanic acid and pristinamycin. Of these physicians, 29.7% declared prescribing a background antibiotic therapy for Hurley 1 stage with less than 4 flares per year, and more than 75% for Hurley 1 stage with more than 4 flares per year, Hurley 2 and Hurley 3 stages; mostly cyclins, combination of rifampicin and clindamycin and sulfamethoxazole-trimethoprim.Conclusion: This survey underlines the heterogeneity in

Published August 23, 2022, The use of spoken and written language is a fundamental human capacity. Individual differences in reading- and language-related skills are influenced by genetic variation, with twin-based heritability estimates of 30 to 80% depending on the trait. The genetic architecture is complex, heterogeneous, and multifactorial, but investigations of contributions of single-nucleotide polymorphisms (SNPs) were thus far underpowered. We present a multicohort genome-wide association study (GWAS) of five traits assessed individually using psychometric measures (word reading, nonword reading, spelling, phoneme awareness, and nonword repetition) in samples of 13,633 to 33,959 participants aged 5 to 26 y. We identified genome-wide significant association with word reading (rs11208009, P = 1.098 × 1028) at a locus that has not been associated with intelligence or educational attainment. All five reading-/language-related traits showed robust SNP heritability, accounting for 13 to 26% of trait variability. Genomic structural equation modeling revealed a shared genetic factor explaining most of the variation in word/nonword reading, spelling, and phoneme awareness, which only partially overlapped with genetic variation contributing to nonword repetition, intelligence, and educational attainment. A multivariate GWAS of word/nonword reading, spelling, and phoneme awareness maximized power for follow-up investigation. Genetic correlation analysis with neuroimaging traits identified an association with the surface area of the banks of the left superior temporal sulcus, a brain region linked to the processing of spoken and written language. Heritability was enriched for genomic elements regulating gene expression in the fetal brain and in chromosomal regions that are depleted of Neanderthal variants. Together, these results provide avenues for deciphering the biological underpinnings of uniquely human traits.

François Hakizayezu,1 Emmanuel Biracyaza,2 Hosee Niyompano,3 Aline Umubyeyi1 1Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; 2Programme of Sociotherapy, Prison Fellowship Rwanda, Kigali, Rwanda; 3Department of Laboratory, Mibilizi District Hospital, Kigali, RwandaCorrespondence: François Hakizayezu; Emmanuel Biracyaza, Tel +250 788681637 ; +250 785686886, Email francohakiza20@yahoo.com; biracyazaemmaus@gmail.comBackground: By the end of 2015, epidemiological studies approximated 37 million people living with HIV (PLHIV) and 46.3% of them were initiated to antiretroviral therapies. From the 90-90-90 strategy, by 2020 at global level, 90% of all people living with HIV were expected to suppress viral load (VL). Although VL suppression is an important indicator of treatment success in PLHIV, studies on this indicator remain scarce in Rwanda where the prevalence of HIV is 3% with 9% for non-suppression. This work, thus, determined the prevalence of VL non-suppression and its associated predictors among PLHIV.Methods: A cross-sectional study was conducted among 637 PLHIV enrolled in healthcare services between 2016 and 2017 in Nyaruguru district. Socio-demographic, treatment, clinical, immunological and VL data were extracted from medical records. Bivariate and multivariate logistic regression analyses were performed to determine associated factors with VL suppression considering 95% confidence intervals and statistical significance of p< 0.005.Results: More than half of participants were female (57.77%). The prevalence of unsuppressed HIV VL was 8.9% and 88.7% of respondents were satisfied with the service provided. Males were more likely to be unsuppressed HIV VL [aOR = 3.02; 95% CI (1.19– 7.64), p = 0.02] than females. Higher likelihoods of VL non-suppression were among those with history of clinical failure [aOR = 3.14; 95% CI (1.70– 14.03), p = 0.034] or history of treatment interr

Jean-Luc Perrot,1,2 François Maccari,2,3 Philippe Guillem,2,4– 6 Anne-Claire Fougerousse,2,7 Aude Nassif,2,8 Nathalie Beneton,2,9 Elisa Cinotti,2,10 Céline Girard,2,11 Raphaelle Binois,2,12 Ziad Reguiaï2,13 On behalf of the ResoVerneuil group1Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France; 2ResoVerneuil, Ville, France; 3Private Office, La Varenne St Hilaire, France; 4Service de chirurgie adulte, clinique du Val-d’Ouest, Ecully, 69130, France; 5European Hidradenitis Suppurativa Foundation, Dessau, Germany; 6Groupe de Recherche En proctologie de la Société Nationale Francophone de Colo-Proctologie, Paris, France; 7Military Teaching Hospital Bégin, Saint Mandé, France; 8Centre Médical de l’Institut Pasteur, Paris, 75015, France; 9Dermatology Department, Centre Hospitalier du Mans, Le Mans, France; 10Department of Medical, Dermatology Unit, Surgical and Neuro.Sciences, University of Siena, Siena, Italy; 11Dermatology Department, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; 12Dermatology Department, Centre Hospitalier Régional d’Orléans, Orléans Cedex, 45067, France; 13Service de dermatologie, polyclinique Courlancy, Reims, 51100, FranceCorrespondence: Jean-Luc Perrot, Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France, Email j.luc.perrot@chu-st-etienne.frPurpose: Hidradenitis suppurativa (HS) is an inflammatory skin disease characterized by recurrent or chronic painful and suppurating lesions in the apocrine gland-bearing regions. The lack of knowledge about HS and its extremely heterogeneous clinical presentation, in terms of both lesion appearance and sites of involvement, frequently delay its diagnosis for several years. Objectives: in this study, using the latent class analysis, it was demonstrated that severit

Guillaume Deschasse,1,2 Elodie Drumez,2,3 Fabien Visade,2,4 Anne Charpentier,5 Céline Delecluse,4 Gilles Loggia,6,7 Pascale Lescure,7 Jadwiga Attier-&Zdot;mudka,8,9 Jennifer Bloch,5 Cédric Gaxatte,5 Frédéric Bloch,1 François Puisieux,5 Jean-Baptiste Beuscart2,5 1Department of Geriatrics, CHU Amiens-Picardie, Amiens, France; 2ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, University Lille, CHU Lille, Lille, France; 3Department of Biostatistics, CHU Lille, Lille, France; 4Geriatrics Department, Lille Catholic Hospitals, Lille, France; 5Department of Geriatrics, CHU Lille, Lille, France; 6COMETE, INSERM, Normandie Univ, UNICAEN, Caen, France; 7Department of Geriatrics, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France; 8Geriatric Department, General Hospital of Saint-Quentin, Saint-Quentin, France; 9CHIMERE EA 7516 Team Research, Jules Verne University, Amiens, FranceCorrespondence: Guillaume Deschasse, Department of Geriatrics, CHU Amiens-Picardie, Amiens, France, Tel +33-322-088-000, Fax + 33-322-455-748, Email deschasse.guillaume@chu-amiens.frBackground: Acute geriatric units (AGUs) require efficient discharge planning tools. Risk factors for discharge from an AGU to post-acute care (PAC) have not previously been investigated in detail.Methods: The objective is to identify risk factors for PAC transfer. The DAMAGE (prospective multicenter cohort) consecutively included more than 3500 subjects aged 75 or older and admitted to an AGU. The patients underwent a comprehensive geriatric assessment (CGA) during their stay in the AGU. Only community-dwelling patients admitted to the AGU from the emergency department were included in the analysis. We recorded the characteristics of the care pathway and identified risk factors for discharge to home or to a PAC facility.Results: 1928 patients were included. Loss of functional independence (a decrease in the Katz activities of daily living (ADL) score between 1 month

Virginie Blanchette,1 Yassin Andoulsi,1 Martine Brousseau,2 Céline Leblanc,3 François Guillemette,4 Olivier Hue1 1Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada; 2Occupational Therapy Department, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada; 3Bureau de pédagogie et de formation à distance (Pedagogy and Distance Education Office), Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada; 4Education Department, Université du Québec à Trois-Rivières, Trois-Rivières, QC, CanadaCorrespondence: Virginie Blanchette, Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, 3351 Boul. Des Forges, Trois-Rivières, QC, G8Z 4M3, Canada, Tel +1-819-376-5011 Extension: 3756, Email Virginie.Blanchette@uqtr.caPurpose: Podiatrists are generally defined as professionals with high-level skills in the prevention and management of local foot conditions that are not systemic diseases. Across countries, different academic trainings are implemented due to the specific context and practice of podiatric medicine. It is thus essential to support country-specific podiatry education for the development of highly skilled podiatrists. Therefore, we report the development of a podiatric medicine competency framework to support training in Canada.Participants and Methods: A Delphi process was conducted by 12 stakeholders (including 8 podiatry experts) from the University of Québec at Trois-Rivières which is the only university offering the degree of Doctor of Podiatric Medicine (DPM) in Canada. The developed framework is (1) based on the seven key roles of the Canadian medical education directives of specialists (CanMEDs) and, (2) closely aligned with the requirement of the College of Podiatrists of Québec which sets the standards of entry to practice in Québec.Results: The developed framework represents the state of the development

Thi Ha Chau Tran,1 Stephane Verdun,2 Jean François Le Rouic,3 Joel Uzzan,4 Solange Milazzo5 ,† Laurent Kodjikian,6 Ali Erginay7 1Ophthalmology Department, Lille Catholic Hospitals, Lille Catholic University, INSERM, U1172, Lille, France; 2Biostatistics Department-Delegations for Clinical Research and Innovation, Lille Catholic Hospitals, Lille, France; 3Institut d’Ophtalmologie de l’Ouest, Nantes, France; 4Clinique Mathilde, Rouen, France; 5Ophthalmology Department, Picardie Jules Verne University, Amiens, France; 6Ophthalmology Department, Hospice Civils de Lyon, Lyon 1 University, UMR-CNRS 5510, Lyon, France; 7Ophthalmology Department, Lariboisière Hospital, Paris University, Paris, France†Solange Milazzo passed away on March 23, 2019Correspondence: Thi Ha Chau Tran, Ophthalmology Department, Lille Catholic Hospitals, Lille Catholic University, INSERM, Boulevard de Belfort – BP387. 59020 Lille Cedex, U1171, France, Tel +33 3 20 87 74 42, Fax +33 20 87 75 58, Email tran.hachau@ghicl.netPurpose: To evaluate the efficacy of intravitreal aflibercept injection (IAI) for vitrectomized eyes with diabetic macular edema (DME) at two years.Methods: This is a prospective, non-comparative, multicenter observational study including diabetic patients with visual acuity between 20/400 to 20/40 due to DME, who have undergone vitrectomy at least 3 months before the first aflibercept injection. Treatment protocol included 5 monthly aflibercept injection followed by a ProReNata regimen during the first year. Participants were managed at clinicians’ discretion using Treat and Extend or Observe and Plan regimen during the second year. Visual acuity, OCT findings and number of IAI were assessed at two years.Results: Available data for 28 eyes with DME previously vitrectomized treated with aflibercept intravitreal injection during at least 2 years were collected. Visual gain was +5.4 letters (p = 0.01)

David Mannino,1 Michael Bogart,2 Guillaume Germain,3 Shirley P Huang,2 Afisi S Ismaila,4,5 François Laliberté,3 Young Jung,3 Sean D MacKnight,3 Marjorie A Stiegler,6,7 Mei Sheng Duh8 1Department of Medicine, University of Kentucky, Lexington, KY, USA; 2GlaxoSmithKline, Value Evidence and Outcomes, Research Triangle Park, NC, USA; 3Groupe d’analyse, Ltée, Montréal, QC, Canada; 4GlaxoSmithKline, Value Evidence and Outcomes, Collegeville, PA, USA; 5Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; 6GlaxoSmithKline, Medical Affairs, Research Triangle Park, NC, USA; 7Department of Anesthesiology and Critical Care, University of North Carolina, Chapel Hill, NC, USA; 8Analysis Group, Boston, MA, USACorrespondence: Michael Bogart, GlaxoSmithKline, Value Evidence and Outcomes, 5 Moore Drive, PO Box 13398, Research Triangle Park, NC, 27709-3398, USA, Tel +1919-889-7413, Email michael.r.bogart@gsk.comPurpose: Triple therapy (TT; inhaled corticosteroid, long-acting muscarinic antagonist, and long-acting β2-agonist) is recommended for patients with chronic obstructive pulmonary disease (COPD) at risk of exacerbation, although the optimum timing of TT initiation remains unclear. This study evaluated the impact of prompt versus delayed initiation of single-inhaler TT (fluticasone furoate, umeclidinium, and vilanterol [FF/UMEC/VI]) following a COPD exacerbation.Patients and Methods: This retrospective cohort study used data from the IQVIA PharMetrics® Plus database. Patients initiating FF/UMEC/VI following a COPD exacerbation between September 18, 2017 and September 30, 2019 (exacerbation = index date) were categorized as prompt (within 30 days of index) or delayed (31– 180 days after index) FF/UMEC/VI initiators. Patients were aged ≥ 40 years at index, had ≥ 12 months’ continuous health insurance coverage before index (baseline), and ≥ 6 months’ coverage after index (follow-up). Patients with a COPD exacerba

Laurine Robert,1 Grégoire Ficheur,2 Sophie Gautier,3 Alexandre Servais,1 Michel Luyckx,4 Julien Soula,1 Bertrand Decaudin,5 François Glowacki,6 François Puisieux,1 Emmanuel Chazard,2 Jean-Baptiste Beuscart1 1Univ. Lille, CHU Lille, EA2694, Lille, F-59000, France; 2Univ. Lille, CHU Lille, EA2694, Public Health Department, Lille, F-59000, France; 3Univ. Lille, CHU Lille, UMR 1171, Department of Pharmacology, Lille, F-59000, France; 4Univ. Lille, EA7365, F-59000 Lille, CH Denain, Department of Pharmacy, Denain, F-59220, France; 5Univ. Lille, CHU Lille, EA7365, Department of Pharmacy, Lille, F-59000, France; 6Univ. Lille, CHU Lille, EA4483 IMPECS, Department of Nephrology, Lille, F-59000, FranceCorrespondence: Laurine RobertCERIM – EA 2694, Faculté de Médecine - Pôle Recherche, 1 Place de Verdun, Lille Cedex 59045 FranceEmail laurine.robert.etu@univ-lille.frPurpose: Community-acquired acute kidney injury (CA-AKI) is a frequent and severe adverse drug reaction (ADR) among older patients. The combination of drugs and other CA-AKI risk factors was barely evaluated. The objectives of our study were to both accurately identify CA-AKI induced by drugs in older patients, and to describe their combination with other risk factors.Patients and methods: We conducted a retrospective, single-center study in a general hospital over a two-year period. An automated detection identified CA-AKI according to KDIGO criteria, amongst 4,767 eligible inpatient stays among patients aged 75 years or older. Two independent experts reviewed all CA-AKI events to adjudicate drug involvement (Naranjo scale), identify inappropriate prescriptions (STOPP criteria), evaluate avoidability (Hallas criteria) and identify combined risk factors.Results: An expert review confirmed 713 CA-AKI (15.0% of inpatient stays) and determined that 419 (58.8%) CA-AKI were induced by drugs. A multifactorial cause (i.e., at least one drug with a pr

Florence Coste,1,2,* Ilyes Benlala,1,2,* Gaël Dournes,1–3 Claire Dromer,3 Elodie Blanchard,3 Pierre-Olivier Girodet,1–3 Michel Montaudon,1–3 Fabien Baldacci,4 François Picard,3 Roger Marthan,1–3 François Laurent,1–3,* Patrick Berger1–3,* 1Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France; 2Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, Université de Bordeaux, CIC1401, F-33000 Bordeaux, France; 3CHU de Bordeaux, Service d’Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Cardiologie, CIC1401, Service d’Explorations Fonctionnelles Respiratoires, F-33600 Pessac, France; 4Université de Bordeaux, LaBRI, F-33405 Talence Cedex, France *These authors contributed equally to this work Background: Little is known about in vivo alterations at bronchial and vascular levels in severe pulmonary hypertension (PH) of different etiologies. We aimed to compare quantitative computed tomography (CT) data from the following three groups of severe precapillary PH patients: COPD, idiopathic pulmonary arterial hypertension (iPAH), and chronic thromboembolic PH (CTEPH). Patients and methods: This study was approved by the institutional review board. Severe PH patients (mean pulmonary arterial pressure [mPAP] ≥35 mmHg) with COPD, iPAH, or CTEPH (n=24, 16, or 16, respectively) were included retrospectively between January 2008 and January 2017. Univariate analysis of mPAP was performed in each severe PH group. Bronchial wall thickness (WT) and percentage of cross sectional area of pulmonary vessels less than 5 mm2 normalized by lung area (%CSA<5) were measured and compared using CT, and then combined to arterial partial pressure of oxygen (PaO2) to generate a “paw score” compared within the three g

Antoine Lapointe,1 Nikyel Royer Moreau,1 David Simonyan,2 François Rousseau,2 Viviane Mallette,1 Frédérique Préfontaine-Racine,1 Caroline Paquette,1 Myriam Mallet,2 Annie St-Pierre,1 Simon Berthelot1,2 1Département de médecine familiale et de médecine d’urgence, Université Laval, Québec, Canada; 2Centre de recherche du CHU de Québec - Université Laval, Québec, CanadaCorrespondence: Antoine LapointeDépartement de médecine familiale et de médecine d’urgence, Université Laval, 1050 Avenue de la Médecine, Québec G1V0A6, CanadaTel +1 418-656-5245Email Antoine.lapointe.1@ulaval.caPurpose: With rising healthcare costs limiting access to care, the judicious use of diagnostic tests has become a critical issue for many jurisdictions. Calcium, magnesium and phosphorus serum levels are regularly performed tests in the emergency department, but their clinical relevance have come into question. Authors sought to determine risk factors that could predict abnormal calcium, magnesium and phosphorus serum levels, as well as identify patients who may need corrective interventions.Methods: A retrospective cohort study was conducted in two academic hospitals in Québec City. Demographic and clinical characteristics of 1008 patients who had serum calcium and/or magnesium and/or phosphorus levels drawn by an emergency physician were collected. Multivariate logistic regression models were fitted to obtain adjusted odds ratios for each risk factor for abnormal calcium or magnesium or phosphorus blood levels, and for a required intervention.Results: Among patients for whom calcium, magnesium and phosphorus were tested in the Emergency Department, the most significant risk factors (OR> 2) for electrolytic abnormality were as follows: hypocalcemia – res

Thierry Habyarimana,1 Didier Murenzi,2 Emile Musoni,2 Callixte Yadufashije,1 François N Niyonzima1 1Biomedical Laboratory Sciences Department/INES-Ruhengeri, Musanze, Rwanda; 2Pathology Department, Centre Hospitalier Universitaire de Kigali, Kigali, RwandaCorrespondence: Thierry Habyarimana P.O.Box 155 Ruhengeri Tel +250783025850Email h.thierry@ines.ac.rwBackground: Worldwide, bacterial bloodstream infections (BSIs) constitute an important cause of morbidity and mortality in clinical settings. Due to the limited laboratory facilities in sub-Saharan Africa, poor diagnosis of BSIs results in poor clinical outcomes and leads to a risk of antimicrobial resistance. The present work was carried out to describe the microbiological features of BSIs using the data collected from Centre Hospitalier Universitaire de Kigali (CHUK).Methods: A retrospective study was carried out at CHUK. The blood culture results of 2,910 cases – from adults, children and infants – were reviewed in the Microbiology service from October 2017 to October 2018. The following variables were considered: age, gender, admitting department, blood culture results, and antimicrobials sensitivity test results. Data were entered and analyzed using Microsoft Excel 2013.Results: Twelve percent (341/2,910) of blood culture results reviewed were positive with 108 (31.7%) Gram positive bacteria and 233 (68.3%) Gram negative bacteria. The most prevalent pathogens were Klebsiella pneumoniae 108 (31.7%) and Staphylococcus aureus 100 (29.3%). This study revealed a high resistance to commonly prescribed antibiotics such as penicillin, trimethoprim sulfamethoxazole, and Ampicillin with 91.8, 83.3, and 81.8% of resistance, respectively. However, bacteria were sensitive to imipenem and vancomycin with 98.1 and 94.3% of sensitivity, respectively. The pediatrics and neonatology departments showed a high number of positive culture with 97/341 (28.4%), and 93/341 (27%) respectively. The overall

Antoine Lapointe,1 Nikyel Royer Moreau,1 David Simonyan,2 François Rousseau,2 Viviane Mallette,1 Frédérique Préfontaine-Racine,1 Caroline Paquette,1 Myriam Mallet,2 Annie St-Pierre,1 Simon Berthelot1,2 1Département de médecine familiale et de médecine d’urgence, Université Laval, Québec, Canada; 2Centre de recherche du CHU de Québec - Université Laval, Québec, CanadaCorrespondence: Antoine LapointeDépartement de médecine familiale et de médecine d’urgence, Université Laval, 1050 Avenue de la Médecine, Québec G1V0A6, CanadaTel +1 418-656-5245Email Antoine.lapointe.1@ulaval.caPurpose: With rising healthcare costs limiting access to care, the judicious use of diagnostic tests has become a critical issue for many jurisdictions. Calcium, magnesium and phosphorus serum levels are regularly performed tests in the emergency department, but their clinical relevance have come into question. Authors sought to determine risk factors that could predict abnormal calcium, magnesium and phosphorus serum levels, as well as identify patients who may need corrective interventions.Methods: A retrospective cohort study was conducted in two academic hospitals in Québec City. Demographic and clinical characteristics of 1008 patients who had serum calcium and/or magnesium and/or phosphorus levels drawn by an emergency physician were collected. Multivariate logistic regression models were fitted to obtain adjusted odds ratios for each risk factor for abnormal calcium or magnesium or phosphorus blood levels, and for a required intervention.Results: Among patients for whom calcium, magnesium and phosphorus were tested in the Emergency Department, the most significant risk factors (OR> 2) for electrolytic abnormality were as follows: hypocalcemia – res

Fabien Visade,1,2 Genia Babykina,1 François Puisieux,3 Frédéric Bloch,4,5 Anne Charpentier,3 Céline Delecluse,2 Gilles Loggia,6,7 Pascale Lescure,7 Jadwiga Attier-&Zdot;mudka,8,9 Cédric Gaxatte,3 Guillaume Deschasse,1,4 Jean-Baptiste Beuscart1,3 1University Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, F-59000, France; 2Geriatrics Department, Lille Catholic Hospitals, Lille, F-59000, France; 3Department of Geriatrics, CHU Lille, Lille, F-59000, France; 4Department of Geriatrics, CHU Amiens-Picardie, Amiens, F-80054, France; 5Laboratory of Functional Neurosciences EA 4559, University of Picardie – Jules-Verne, Amiens, France; 6UNICAEN, INSERM, COMETE, Normandie Univ, Caen, France; 7Department of Geriatrics, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France; 8Geriatric Department, General Hospital of Saint-Quentin, Saint-Quentin, France; 9CHIMERE EA 7516 Head and Neck Research Group, Jules Verne University, Amiens, FranceCorrespondence: Fabien VisadeUniversity Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, F-59000, FranceTel +33-320-626-969Fax +33-320-626-881Email fabien_v59@hotmail.comObjective: To analyze the impact of the number of hospital readmissions on the risks of further hospital readmission and death after adjustment for a range of risk factors.Methods: We performed a multicentre prospective study of the DAMAGE cohort in the Hauts-de-France region of France. Patients aged 75 and over hospitalized initially in an acute geriatric unit (AGU) were included and followed up for 12 months. The risk of hospital readmission was analyzed using a Cox model, and its extension for recurrent events and the risk of death were analyzed using a Cox model for time-dependent variables.Results: A total of 3081 patients were included (mean (SD) age: 86.4 (5.5)). In the multivariate analysis, the relative risk (95% confidence i

Céline Gélinas,1,2 Shiva Shahiri T,1,2 Melissa Richard-Lalonde,1,2 Denny Laporta,3,4 Jean-François Morin,5,6 Madalina Boitor,7 Catherine E Ferland,8,9 Patricia Bourgault,10 Philippe Richebé11 1Ingram School of Nursing, McGill University, Montreal, QC, Canada; 2Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital – CIUSSS West-Central Montreal, Montreal, QC, Canada; 3Faculty of Medicine, Respiratory Division, McGill University, Montreal, QC, Canada; 4Department of Medicine, Division of Adult Critical Care, Jewish General Hospital – CIUSSS West-Central Montreal, Montreal, QC, Canada; 5Faculty of Medicine, Department of Surgery, Division of Cardiac Surgery, McGill University, Montreal, QC, Canada; 6Department of Surgery, Cardiac Surgery, Jewish General Hospital – CIUSSS West-Central Montreal, Montreal, QC, Canada; 7Faculty of Dentistry, McGill University, Montreal, QC, Canada; 8Faculty of Medicine, Department of Anesthesia, McGill University, Montreal, QC, Canada; 9Shriners Hospitals for Children – Canada, Montreal, QC, Canada; 10Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, QC, Canada; 11Department of Anesthesiology and Pain Medicine, Maisonneuve-Rosemont Hospital – CIUSSS de l’Est-de-l’Île-de-Montréal – Université de Montréal, Montreal, QC, CanadaCorrespondence: Céline GélinasIngram School of Nursing – McGill University, 680, Sherbrooke West, Suite 1800, Montreal, QC, H3A 2M7, CanadaTel +1 514 398 6157Fax +1 514 398 8455Email celine.gelinas@mcgill.caIntroduction: The aim of this study was to explore the use of a multi-parameter technology, the Nociception Level (NOL) index (Medasense Biometrics Ltd, Ramat Gan, Israel), for pain assessment in postoperative awake patients after cardiac surgery during non-nociceptive and nociceptive procedures in the intensive care unit (ICU).Materials and Methods: A prospective cohort repeated-measures design was used. Patients wer

Thibaud Soumagne, Florence Levesque, Julie Milot, Krystelle Godbout, Yves Lacasse, François Maltais Service de pneumologie, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, CanadaCorrespondence: Thibaud SoumagneService de pneumologie, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, CanadaEmail thibaud_soumagne@live.frIntroduction: Stenotrophomonas maltophilia is an emerging Gram-negative MDR bacteria. In patients with chronic obstructive pulmonary disease (COPD), it is mostly found in those with severe exacerbation of COPD requiring mechanical ventilation. The significance of S. maltophilia when detected in the sputum of ambulatory patients with COPD is uncertain.Objective: To access the prevalence and the risk factors of the presence of S. maltophilia in the sputum of ambulatory patients with COPD and to determine whether it was associated with prognosis.Methods: All consecutive unselected ambulatory patients with GOLD 2– 4 COPD were recruited between January 2017 and September 2019 from the COPD clinic of a tertiary care hospital. Presence of S. maltophilia was defined by a positive sputum culture for S. maltophilia. Demographics, COPD characteristics, comorbidities and known predisposing risk factors associated with S. maltophilia were collected from medical records.Results: S. maltophilia was detected in the sputum of 41/393 (10%) of study participants. Comorbidities, exacerbation, use of oral steroids and carbapenems in the previous year were risk factors for the presence of S. maltophilia. After adjusting on confounding factors associated with mortality including age, Charlson comorbidity index and FEV1, S. maltophilia was significantly associated with mortality (adjusted hazard ratio 2.3; 95% CI 1.1– 4.9).Conclusion: In the current study, we found that 10% of ambulatory patients with GOLD 2– 4 COPD had S. maltophilia detected in their sputum. In addit

Soham Shukla,1 Dhvani Shah,2 Alan Martin,3 Nancy A Risebrough,4 Robyn Kendall,5 Claus F Vogelmeier,6 Isabelle Boucot,3 Lee Tombs,7 Leif Bjermer,8 Paul W Jones,3 Edward Kerwin,9 Chris Compton,3 François Maltais,10 David A Lipson,11,12 Afisi S Ismaila1,13 1Value Evidence and Outcomes, GSK, Collegeville, PA, USA; 2ICON, New York, NY, USA; 3Value Evidence and Outcomes, GSK, Brentford, Middlesex, UK; 4Global Health Economics, and Outcomes Research and Epidemiology, ICON, Toronto, ON, Canada; 5Global Health Economics, and Outcomes Research and Epidemiology, ICON, Vancouver, BC, Canada; 6Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-Universität Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany; 7Precise Approach Ltd, Contingent Worker on Assignment at GSK, Brentford, Middlesex, UK; 8Respiratory Medicine and Allergology, Lund University, Lund, Sweden; 9Altitude Clinical Consulting and Clinical Research Institute of Southern Oregon, Medford, OR, USA; 10Centre de Pneumologie, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, QC, Canada; 11Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 12Respiratory Clinical Sciences, GSK, Collegeville, PA, USA; 13Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, CanadaCorrespondence: Afisi S IsmailaValue Evidence and Outcomes, GlaxoSmithKline 1250 South Collegeville Road, Collegeville, PA, 19426-0989, USATel +1 919 315 8229Email afisi.s.ismaila@gsk.comIntroduction: Dual bronchodilators are recommended as maintenance treatment for patients with symptomatic COPD in the UK; further evidence is needed to evaluate cost-effectiveness versus monotherapy. Cost-effectiveness of umeclidinium/vilanterol versus umeclidinium and salmeterol from a UK healthcare perspective in patients without exacerbations in the previous year was as

Andrea Fabbri,1 Alberto M Borobia,2 Agnes Ricard-Hibon,3 Frank Coffey,4 Aurore Caumont-Prim,5 François Montestruc,5 Amedeo Soldi,6 Susana Traseira Lugilde,7 Sara Dickerson8 1Department of Emergency Medicine, Morgagni-Pierantoni Hospital, Forli, Italy; 2Clinical Pharmacology Department, La Paz University Hospital, School of Medicine, Universidad Autónoma de Madrid, IdiPAZ, Madrid, Spain; 3Emergency Department SAMU-SMUR 95, CHG Pontoise-Beaumont/Oise, Pontoise, France; 4DREEAM: Department of Research and Education in Emergency Medicine, Acute Medicine and Major Trauma, Nottingham University Hospitals NHS Trust, Nottingham, UK; 5eXYSTAT, Malakoff, France; 6Mundipharma Pharmaceuticals Srl, Milan, Italy; 7Mundipharma Pharmaceuticals S.L., Madrid, Spain; 8Mundibiopharma Limited, Cambridge, UKCorrespondence: Sara DickersonMundibiopharma Limited, Cambridge Science Park, Milton Road, Cambridge CB4 0AB, UKTel +44 1223 397684Email Sara.Dickerson@mundipharma.comPurpose: Undertreatment of trauma-related pain is common in the pre-hospital and hospital settings owing to barriers to the use of traditional standard of care analgesics. Low-dose methoxyflurane is an inhaled non-opioid analgesic with a rapid onset of pain relief that is approved for emergency relief of moderate-to-severe trauma-related pain in adults. This analysis was performed to compare the efficacy and safety of low-dose methoxyflurane with standard of care analgesics in adults with trauma-related pain.Methods: A meta-analysis was performed on pooled data from randomized controlled trials identified via a systematic review. The primary endpoint was the pain intensity difference between baseline and various time intervals (5, 10, 15, 20, and 30 minutes) after initiation of treatment.Results: The pain intensity difference was statistically superior with low-dose methoxyflurane compared with standard of care analgesics (overall estimated treatment effect=11.88, 95% CI=9.75– 14.00; P&amp

Thi Ha Chau Tran,1 Ali Erginay,2 Stephane Verdun,3 Eric Fourmaux,4 Jean-François Le Rouic,5 Joel Uzzan,6 Solange Milazzo7 ,† Stephanie Baillif,8 Laurent Kodjikian9 1Service d’Ophtalmologie, Université Catholique de Lille, Faculté de Médecine et Maieutique, INSERM U1171, Lille, France; 2Service d’Ophtalmologie, Hôpital Lariboisière APHP, Universite de Paris, Paris, France; 3Département de Recherche Médicale, Groupement des Hôpitaux Catholiques de Lille, Lille, France; 4Centre Rétine Gallien, Bordeaux, France; 5Institut Ophtalmologique de l’Ouest Jules Verne, Ophtalliance, Nantes, France; 6Clinique Mathilde, Rouen, France; 7Service d’Ophtalmologie, Centre Hospitalier Universitaire d’Amiens Picardie, Université de Picardie Jules Verne, Amiens, France; 8Service d’Ophtalmologie, Centre Hospitalier Université Côte d’Azur, Université Côte d’Azur, Nice, France; 9Service d’Ophtalmologie, Croix Rousse Hospital, Hospice Cilvils de Lyon 1, Université de Lyon 1, Lyon, France†Solange Milazzo passed away on March 23, 2019Correspondence: Thi Ha Chau TranService d’Ophtalmologie, Université Catholique de Lille, Faculté de Médecine et Maieutique, INSERM U1171, Boulevard de Belfort, BP387, Lille, Cedex, 59021, FranceTel +33 3 20 87 74 42Fax + 33 20 87 75 58Email tran.hachau@ghicl.netAim: To evaluate the efficacy of intravitreal Aflibercept injection (IAI) for vitrectomized eyes with diabetic macular edema (DME) at one year.Methods: This is a prospective, non-comparative, multicenter observational study including diabetic patients whose HbA1c is < 9%, with visual acuity between 20/400 to 20/40 due to DME, who have undergone vitrectomy since at least 3 months

Leif Bjermer,1 Isabelle H Boucot,2 François Maltais,3 Edward M Kerwin,4 Ian P Naya,2 Lee Tombs,5 Paul W Jones,2 Chris Compton,2 David A Lipson,6,7 Claus F Vogelmeier8 1Respiratory Medicine and Allergology, Lund University, Lund, Sweden; 2Global Specialty & Primary Care, GSK, Brentford, Middlesex, UK; 3Centre de Pneumologie, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada; 4Clinical Research Institute of Southern Oregon, Medford, OR, USA; 5Precise Approach Ltd, contingent worker on assignment at GSK, Stockley Park West, Uxbridge, Middlesex, UK; 6Respiratory Clinical Sciences, GSK, Collegeville, PA, USA; 7Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 8Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-Universität Marburg, Member of the German Center for Lung Research (DZL), Marburg, GermanyCorrespondence: Leif BjermerRespiratory Medicine and Allergology, Skane University Hospital, 221 85 Lund, SwedenTel +46 46 17 23 25Email leif.bjermer@med.lu.seIntroduction: Limited prospective evidence is available to guide selection of first-line maintenance therapy in patients with COPD. This pre-specified analysis of the EMAX trial explored the efficacy and safety of dual- versus mono-bronchodilator therapy in maintenance-naïve and maintenance-treated patients.Methods: The 24-week EMAX trial evaluated lung function, symptoms (including rescue medication use), exacerbations, and safety with umeclidinium/vilanterol, umeclidinium, and salmeterol in symptomatic patients at low exacerbation risk who were not receiving inhaled corticosteroids. Maintenance-naïve and maintenance-treated subgroups were defined by maintenance bronchodilator use 30 days before screening.Results: The analysis included 749 (31%) maintenance-naïve and 1676 (69%) maintenance-treated patients. For both subgroups, improvements from baseline in trough

Sarah Gephine,1,2 Patrick Mucci,1 Jean-Marie Grosbois,3 François Maltais,2 Didier Saey2 1University Lille, University Artois, University Littoral Côte d’Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, F-59000, France; 2Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada; 3Formaction Santé, Pérenchies, FranceCorrespondence: Didier SaeyInstitut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, 2725 Chemin Sainte-Foy, Québec, QC, G1V 4G5 CanadaEmail Didier.saey@rea.ulaval.caBackground: The prevalence of physical frailty and its clinical characteristics in advanced chronic obstructive pulmonary disease (COPD) is unknown, as well as the usefulness of functional capacity tests to screen for physical frailty. The aim of the study was to evaluate the proportion and clinical portrait of COPD patients with chronic respiratory failure exhibiting physical frailty at the time of referral to home-based pulmonary rehabilitation. We also evaluate the usefulness of the short physical performance battery (SPPB) and timed-up and go (TUG) as potential screening tools for physical frailty. Finally, we evaluated the specific contribution of gait speed to the frailty Fried total score.Methods: This was a prospective observational study in which physical frailty was defined using Fried criteria (body mass loss, exhaustion, low physical activity, slower walking and weakness). Clinical portrait was documented from daily physical activity, exercise tolerance, functional capacity, anxiety and depressive symptoms, health-related quality of life, and fatigue scores. The ability of the SPPB and TUG to predict physical frailty was investigated using receiver operating characteristic curves. Contribu

Ravi Kalhan,1 David Slade,2 Riju Ray,2 Chad Moretz,3 Guillaume Germain,4 François Laliberté,4 Qin Shen,5 Mei Sheng Duh,6 Sean Dale MacKnight,4 Beth Hahn3 1Asthma and COPD Program, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; 2US Medical Affairs, GlaxoSmithKline, Research Triangle Park, NC, USA; 3US Value Evidence and Outcomes, GlaxoSmithKline, Research Triangle Park, NC, USA; 4Groupe d’Analyse, Ltée, Montréal, QC, Canada; 5US Value Evidence and Outcomes, GlaxoSmithKline, Collegeville, PA, USA; 6Analysis Group, Inc., Boston, MA, USACorrespondence: Beth HahnUS Value Evidence and Outcomes, GlaxoSmithKline, 5 Moore Drive, Research Triangle Park, NC, 27709-3398, USATel +1 919-274-0660Email Beth.a.hahn@gsk.comBackground: Comorbidities in patients with chronic obstructive pulmonary disease (COPD) are associated with increased medical costs and risk of exacerbations. This study compared COPD-related medical costs and exacerbations in high-cost, high-comorbidity patients with COPD receiving initial maintenance treatment (IMT) with umeclidinium/vilanterol (UMEC/VI) versus fluticasone propionate/salmeterol (FP/SAL), budesonide/formoterol (B/F), or tiotropium (TIO).Methods: This retrospective, matched cohort study identified patients from Optum’s de-identified Clinformatics Data Mart database who initiated UMEC/VI, FP/SAL, B/F, or TIO between January 1, 2014 and December 31, 2018 (index date defined as date of the first fill). Eligibility criteria included age ≥ 40 years at index, ≥ 1 pre-index COPD diagnosis, no pre-index asthma diagnosis, 12 months of continuous insurance coverage pre-index, and high pre-index costs (≥ 80th percentile of IMT population) and comorbidities (Quan-Charlson comorbidity index ≥ 3). Propensity score matching was used to control for potential confounders. On-treatment COPD-related medi

Evgeni Mekov,1 Alexa Nuñez,2 Don D Sin,3 Masakazu Ichinose,4 Chin Kook Rhee,5 Diego Jose Maselli,6 Andréanne Coté,7 Charlotte Suppli Ulrik,8,9 François Maltais,7 Antonio Anzueto,6 Marc Miravitlles2 1Department of Occupational Diseases, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria; 2Pneumology Department, Hospital Universitari Vall d´Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain; 3Centre for Heart Lung Innovation, St. Paul’s Hospital, Department of Medicine (Respiratory Division), University of British Columbia, Vancouver, BC, Canada; 4Academic Center of Osaki Citizen Hospital, Miyagi, Japan; 5Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; 6Division of Pulmonary Diseases & Critical Care, University of Texas Health, South Texas Veterans Health Care System, San Antonio, TX, USA; 7Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada; 8Department of Pulmonary Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark; 9Institute of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkCorrespondence: Marc MiravitllesPneumology Department, Hospital Universitari Vall d´Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, SpainEmail marcm@separ.esAbstract: Although chronic obstructive pulmonary disease (COPD) and asthma are well-characterized diseases, they can coexist in a given patient. The term asthma–COPD overlap (ACO) was introduced to describe patients that h

Malcolm Begg,1 J Nicole Hamblin,1 Emily Jarvis,2 Glyn Bradley,3 Stephen Mark,4 David Michalovich,5 Mark Lennon,6 Hannah E Wajdner,5 Augustin Amour,5 Robert Wilson,1 Ken Saunders,5 Rikako Tanaka,7 Saki Arai,7 Teresa Tang,8 Cedric Van Holsbeke,9 Jan De Backer,9 Wim Vos,9 Ingrid L Titlestad,10 J Mark FitzGerald,11 Kieran Killian,12 Jean Bourbeau,13 Claude Poirier,14 François Maltais,15 Anthony Cahn,1 Edith M Hessel1 1Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, UK; 2Biostatistics, GlaxoSmithKline R&D, Stevenage, UK; 3Computational Biology, Medicinal Science and Technology, GlaxoSmithKline, Stevenage, UK; 4Study Management, Clinical Development, GlaxoSmithKline, Mississauga, ON, Canada; 5Adaptive Immunity Research Unit, GlaxoSmithKline, Stevenage, UK; 6Nonclinical and Translational Statistics, GlaxoSmithKline, Stevenage, UK; 7Data Management & Strategy, Clinical Development, GlaxoSmithKline, Tokyo, Japan; 8Pharma Safety, Clinical Development, GlaxoSmithKline, Brentford, Middlesex, UK; 9FLUIDDA nv, Kontich, 2550, Belgium; 10Department of Respiratory Medicine, Odense University Hospital and University of Southern Denmark, Odense, Denmark; 11Centre for Heart and Lung Health, University of British Columbia, Vancouver, BC, Canada; 12Cardiorespiratory Research Laboratory, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; 13Department of Medicine, Division of Experimental Medicine, McGill University, Montreal, QC, Canada; 14Department of Medicine, Respiratory Medicine Division, University of Montreal, Montreal, QC, Canada; 15Institut Universitaire de Cardiologie et de Pneumologie de Québe, Université Laval, Quebec City, QC, CanadaCorrespondence: Malcolm BeggRefractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, Herts, UKEmail malcolm.5.begg@gsk.comBackground: Inhibition of phosphoinositide 3-kinase δ (PI3K&delta

Claus F Vogelmeier,1 Ian P Naya,2,3 François Maltais,4 Leif Bjermer,5 Edward M Kerwin,6 Lee Tombs,7 Paul W Jones,2 Chris Compton,2 David A Lipson,8,9 Isabelle H Boucot2,10 1Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-Universität Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany; 2Global Specialty & Primary Care, GSK, Brentford, Middlesex, UK; 3RAMAX Ltd, Bramhall, Cheshire, UK; 4Centre De Pneumologie, Institut Universitaire De Cardiologie Et De Pneumologie De Québec, Université Laval, Québec, Canada; 5Respiratory Medicine and Allergology, Lund University, Lund, Sweden; 6Altitude Clinical Consulting and Clinical Research Institute of Southern Oregon, Medford, OR, USA; 7Precise Approach Ltd, Contingent Worker on Assignment at GSK, Brentford, Middlesex, UK; 8Respiratory Clinical Sciences, GSK, Collegeville, PA, USA; 9Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 10Medical Emerging Markets, GSK, Brentford, Middlesex, UKCorrespondence: Claus F VogelmeierUniversity Medical Center Giessen and Marburg, Philipps-Universität Marburg, Member of the German Center for Lung Research (DZL), Baldingerstraße, Marburg, 35043, GermanyTel +49 6421/58-66451Email claus.vogelmeier@med.uni-marburg.deIntroduction: This post hoc analysis of the “Early MAXimization of bronchodilation for improving COPD stability” (EMAX) trial investigated whether patients achieving early clinically important improvement (CII) sustained longer-term improvements and lower risk of clinically important deterioration (CID).Methods: Patients were randomized to umeclidinium/vilanterol, umeclidinium, or salmeterol for 24 weeks. The patient-reported outcomes (PROs) Transition Dyspnea Index (TDI), Evaluating Respiratory Symptoms, St George’s Respiratory Questionnaire (SGRQ) an

Anne-Claire Fougerousse,1 Caroline Jacobzone,2 Laure Mery-Bossard,3 Ziad Reguiai,4 Catherine Droitcourt,5 Charles Taieb,6 François Maccari7 On behalf of GEM ResoEczema Group1Dermatology Department, Hôpital d’Instruction des Armées Bégin, Saint Mandé, Val de Marne, France; 2Dermatology Department, Hôpital du Scroff, Groupe Hospitalier Bretagne Sud, Lorient, Morbihan, France; 3Dermatology Department, Centre Hospitalier Intercommunal Poissy Saint Germain en Laye, Saint-Germain-en-Laye, Yvelines, France; 4Dermatology Department, Polyclinique Courlancy, Reims, Marne, France; 5Dermatology Department, Centre Hospitalier Universitaire, Rennes, Ille et Vilaine, France; 6Emma Clinic, Fontenay-sous-Bois, Val de Marne, France; 7Private Practice, Saint-Maur-des-Fossés, Val de Marne, FranceCorrespondence: Anne-Claire FougerousseDermatology Department, Hôpital d’Instruction des Armées Bégin, Saint Mandé, Val de Marne, FranceEmail ac.fougerousse@gmail.comPurpose: Recent studies have illustrated that systemic medications are underused for treating adult atopic dermatitis (AD) and that dermatologists have concerns regarding the safety profile of cyclosporine in AD.Patients and Methods: We performed a national online practice survey between March and April 2020.Results: A total of 305 dermatologists responded, 57% with hospital-based activity and 43% with private practice. Overall, 46.9% prescribed cyclosporine for adult AD. Before initiating treatment, 56.9% did not perform evaluation scoring. Reasons for not prescribing cyclosporine were no eligible patients (24.7%), lack of information (52.6%), need for hospital prescription (31.2%), and lack of experience (79.2%). Fifty-four percent of the dermatologists prescribed methotrexate for adult AD. Before initiating treatment, 50.5% did not perform evaluation scoring. Reasons for not prescribing methot

Clarus Leung,1 Jean Bourbeau,2 Don D Sin,1 Shawn D Aaron,3 J Mark FitzGerald,4 François Maltais,5 Darcy D Marciniuk,6 Denis O’Donnell,7 Paul Hernandez,8 Kenneth R Chapman,9 Brandie Walker,10 Jeremy D Road,4 Liyun Zheng,1 Carl Zou,1 James C Hogg,1 Wan C Tan1 On behalf of the CanCOLD Collaborative Research Group1Centre for Heart Lung Innovation, St Pauls Hospital, The University of British Columbia, Vancouver, BC, Canada; 2Research Institute McGill University Health Centre, McGill University, Montreal, Quebec, Canada; 3The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; 4Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada; 5Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada; 6Respiratory Research Centre, University of Saskatchewan, Saskatoon, Canada; 7Department of Medicine, Queen’s University, Kingston, Canada; 8Department of Medicine, Dalhousie University, Halifax, Canada; 9Toronto General Hospital Research Institute, University of Toronto, Toronto, Canada; 10Department of Medicine, University of Calgary (BW), Alberta, CanadaCorrespondence: Wan C TanCentre for Heart Lung Innovation, St. Paul’s Hospital, University of British Columbia, Rm 166, 1081 Burrard Street, Vancouver, B.C, V6Z 1Y6, CanadaTel +1-604-682-2344 ext 62749Fax +1-604-806-9274Email wan.tan@hli.ubc.caPurpose: To determine the spirometric-based prevalence of COPD across different regions in Canada and to evaluate the site heterogeneity of risk factors.Patients and Methods: In this cross-sectional, population-based study, random samples of non-institutionalized adults aged ≥ 40 years were generated by random digit dialling. Participants answered an interviewer-administered questionnaire and performed spirometry before and after bronchodilator administration. COPD was defined as post-bronchodilator FE